Horsham Workers’ Comp Lawyer
Workers in and around Horsham might be surprised to find that, after a work injury, they might be unable to sue their employer for what happened. Instead, Workers’ Compensation is there to help you get the replacement wages and medical care you need, though the process is often very confusing and you should always seek help from a Workers’ Comp lawyer.
Our attorneys help injured workers and their families get the benefits they need through negotiations with the insurance carrier and petitions filed with a Workers’ Comp Judge. No matter what stage of your case you are in, we can help you file for benefits, keep your benefits coming, and work to get denials overturned.
For a free case evaluation, call our Certified Pennsylvania Workers’ Compensation Specialists at Cardamone Law today at (267) 651-7945.
The Process of Filing for Workers’ Comp in Horsham, PA
Workers who are injured on the job can file a Workers’ Compensation claim through a few steps, all of which our Workers’ Comp attorneys can help you through. Once your claim is filed, there are stages where supporting information might need to be brought forth, where medical exams take place, and where you may even need to go back to court later in the case.
Initial Claim
Your initial claim starts with notice to your employer about the injury. The employer then files with their Workers’ Comp carrier for coverage. If either the employer or their insurance carrier thinks your injury is not work-related or that it does not result in sufficient inability to work, your claim may be denied. It might also be ignored or denied without good reasons, but this can lead to additional penalties for the employer down the road if we win your case, potentially including awarded attorney’s fees.
Claim Petition
Once your employer denies your claim, we can file a petition with a Workers’ Comp Judge (WCJ). These judges are specialized and hear claims specifically for Workers’ Comp, not other types of court cases. When we file your claim petition, we explain what happened, why your injury is covered, and what benefits you need. Benefits typically include the full cost of medical care, wage-loss/“indemnity” benefits (typically at 2/3 your normal pay rate or 2/3 the difference in pay during light-duty/restricted work), and a potential for additional “specific loss” benefits to pay you for an amputation, loss of function, lost hearing, lost sight, or serious facial scarring.
From there, the insurance carrier will typically challenge the petition, though it is possible we could negotiate settled benefits or a lump sum settlement at this stage instead.
Workers’ Comp Hearings
If the case goes to a hearing on your claim petition, the judge will hear evidence and potentially request medical exams to answer the core issues in the case: was the injury work-related, and is the worker disabled enough to need wage-loss benefits?
Later in the case, your case might go back before a WCJ to answer different questions based on other petitions, such as an employer’s petition to terminate benefits, your petition to reinstate benefits, other petitions for reconsideration, or a petition for supersedeas to immediately cut off your benefits.
Medical Exams
Your medical care is separate from the kinds of exams the insurance carrier or WCJ might request. The purpose of your treatment from your treating physician or care provider is to get you healed up and back to work; the purpose of a medical exam, such as an independent medical examination (IME), impairment rating evaluation (IRE), or utilization review (UR), is to provide the employer or the court with some kind of information to help make decisions about your case.
IMEs are used by the insurance carrier to analyze your condition and the severity of it to see if they truly need to pay you, and courts might also request IMEs at various points for similar analyses. IREs are used to rate your disability to determine if it is partial or total. URs are used to determine whether or not a medical procedure or treatment is medically necessary to help determine whether or not the insurance carrier should be forced to cover it.
Keeping Your Benefits
Once you get ongoing benefits granted, you may need to go back to court to defend them at various points. Once your employer can start requesting IMEs after 2 years on benefits, they can check your disability status every 6 months and try to shut down your benefits, but our lawyers can step in to argue that you should remain on benefits.
If you settle your case for a lump sum, you often do not need to worry about getting benefits turned off, as they have already agreed to pay you the stated amount.
Changing Benefits
As you heal and return to work, you may go from total disability benefits to partial disability benefits. If your injury gets worse again, you may go back on total disability. If you heal up and are able to return to work at full capacity, benefits might stop – but they might be needed again if the injury flares back up. As such, there may be petitions to file or counter along the way as your disability status changes and benefits need to be terminated or reinstated.
Appealing Denials
If the initial claim is denied, we take the case to a WCJ under a claim petition. If that gets denied, we can appeal the claim to the Workers’ Compensation Appeal Board (WCAB), and then to the Commonwealth Court and even potentially the Pennsylvania Supreme Court if denials continue. The same is true for other denials and incorrect legal decisions along the way.
Seeking Sanctions and Penalties
Along the course of your case, your insurance carrier or employer might try to break the rules, delay your claim, or even deny your claim with no good reason. This can result in penalty petitions that can pay you additional money for the harm caused. We can also potentially request to have attorney’s fees paid by the defendant if they denied your claim unreasonably.
Call Our Workers’ Compensation Attorneys in Horsham Today
For a free case evaluation, call (267) 651-7945 to speak with Cardamone Law’s Workers’ Comp attorneys.
